Transforming the Face of Surgery around the World

Written By:
Michelle Brubaker

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When a baby in the United States is born with a cleft lip and palate, a condition where the structure of the face does not fuse together properly during gestation, reconstructive surgery is performed before the age of one. Across the world in Malawi, Africa, those born with this deformity are usually abandoned by their families and shunned by society.

“Many of these individuals in Malawi living with this deformity have never been kissed, are forced to live alone and don’t have the option of getting married and having families of their own,” said Amanda Gosman, MD, plastic surgeon with the University of California, San Diego Health System.

Deeply impacted by this news, Gosman coordinated a team of volunteers to travel more than 8,000 miles to provide much needed surgical and follow up care to this underserved population.

“It was important for our team to not only perform the reconstructive surgeries, but to teach the medical team in Malawi how to use their local resources to build a permanent and sustainable program to care for additional patients after our team departed. Through education and the set-up of a telemedicine system, our goal was to continue care for patients after the initial surgeries were performed,” said Gosman, associate clinical professor at UC San Diego School of Medicine.

The group included volunteers from across the nation through ConnectMed International - a non-profit organization founded by Gosman that provides resources to perform reconstructive surgeries around the world on children and adults.

When arriving in Malawi, Gosman was struck by the relationships formed among patients, who were brought together from around the country.

“Many of our patients traveled for days by bus and on foot for the chance of having surgery, hoping for what they thought was impossible—to look normal,” said Gosman. “Most of them had never seen or interacted with others who had similar deformities. They realized they were not alone. The children all ran around playing together. That in itself was life-changing for them.”

Through a multi-disciplinary approach, the team successfully performed 40 reconstructive surgeries on patients ranging from two months to 24-years-old during the week long journey.

“Before our arrival, there was no opportunity for surgical repair on these patients,” said Gosman. “But through our efforts, patients were dancing and celebrating together post-surgery, and some even smiled for the first time. We improved their quality of life, which will help them achieve their full potential.”

Now back from the outreach trip, Gosman is able to provide follow up care and even assist surgeons in Malawi through telemedicine, which has allowed her to establish long-term relationships with health care partners and collaborate on projects to improve medicine in countries such as Mexico and India.

“I can continue to educate and consult the medical team in Malawi while sitting at my desk in San Diego. This is the future of medicine, and it’s important we train our medical students in this domain.”

Although the trip was seven days, Gosman said everyone on the team took something away that will benefit their work for years to come.

“This trip made us all more compassionate as people and professionals,” said Gosman. “It has put everything in perspective.”

A return trip to Malawi is already tentatively scheduled for the group in 2014 to perform reconstructive surgery on new patients. Gosman is also currently leading a telemedicine project in Mexico, which is providing several teaching opportunities for UC San Diego medical students and residents, who learn how to be resourceful in a limited surgical environment and coordinate patient care in an international setting through technology.

As a high school student, Gosman said she dreamed of a career that would bring positive change and truly make a different to those in need.

“Our trip to Malawi is the compilation of decades of dreams coming true,” said Gosman.